Treatment of missed abortion

After establishing a definitive diagnosis of missed abortion the fetus from the uterus must be removed. If the woman's condition allows, doctors sometimes take a wait that is waiting for the body itself to get rid of the dead fetus by miscarriage or premature birth.

But today, experts are still trying to remove the contents of the uterus surgically, without waiting for complications. The choice is usually depends observed in women vaginal bleeding or not. The presence of brownish discharge or bleeding suggests that miscarriage happens, but sometimes it is necessary to wait several days or even weeks. In most cases, the doctor recommends an operation no more than a few days, to reduce the chance of infection of the uterus. It may be better in terms of the emotional state of a woman - to know that the fruit of the womb is dead psychologically very difficult.

Interruption of missed abortion, depending on its term medication can be carried in a manner using vacuum extraction (mini-abortion), curettage, or induction of labor.

Medical termination of missed abortion

Medical abortion when pregnancy results of missed during a period not exceeding 42 days from the date of the last menstrual period in a hospital. The woman in the presence of a doctor taking pills (usually mifepristone), and then a few hours later she appeared spotting Spotting - it is important to rule out pathology . Usually, within two days the embryo died completely out of the uterus, which must be confirmed by ultrasound. To enhance uterine contractility some women appoint additional prostaglandins. Repeated ultrasound to confirm complete removal of the ovum is conducted through one or two weeks. Simultaneously, the re-determination of hCG in the blood. If there was an incomplete abortion, curettage is performed Scraping - heavy and unsafe procedure   the uterine cavity.

Scraping in the missed abortion

The operation is performed for up to 12 weeks or in the case of incomplete abortion caused by other methods. Scraping after missed abortion is performed under general anesthesia. In this first expands the cervical canal, then it entered a long-handled spoon (curette), through which the entire scraping the surface layer of the mucous membrane of the wall and with it removed the ovum.

Cleaning in the missed abortion operation is complete, so it can have complications. In the context of specialized units such complications tend to cope successfully. To prevent infection prescribe antibiotics, and to stop bleeding - modern drugs that contribute to a rapid reduction of muscles of the uterus (the vessels are compressed) and the increase of blood clotting.

Artificial birth in the missed abortion

This type of abortion performed in the second half for a period of over 22 weeks, and only in a hospital. Women prescribed drugs that stimulate the contractile activity of uterine muscles. This triggers the birth and missed first trimester the fetus is removed from the uterus. After artificial birth Artificial birth or abortion in the later stages   held ultrasound control.

How to survive a missed abortion a woman? Often missed abortion, especially if it occurred in the second half, accompanied by persistent depression Depression - a little more than a bad mood . In some cases, women are even required psychiatric help. But more help to cope with depression close - it is their sensitive attitude can overcome psychological difficulties.

The doctor for his part explained to the woman that missed abortion - it is not a sentence, and in most cases the case of a successful pregnancy after the stood.

Avoiding missed abortion

Missed abortion can occur in any woman. How to prevent missed abortion, talk to the women's clinic. To do this, avoid all the factors contributing to its development.

It could happen again missed abortion? In most cases it will not be repeated, but if it happened twice, then you need to see a doctor.

Galina Romanenko

The threat of interruption is considered one of the most frequent pathologies of pregnancy. Almost half of expectant mothers went through this state. To understand the fear and excitement of women with threatened abortion can only be the woman who she is, or is preparing to become a mother. Diagnosis threat unpleasant interruption, not only for pregnant women, but also for the doctor. But the main thing is not to delay the process and promptly seek medical attention, but in this case it is possible to continue the pregnancy and forget about the threat of an interruption as a nightmare.

Threat of abortion

The threat of termination of pregnancy are divided into two groups. If the developing threat of termination before the deadline of 28 weeks - is the risk of miscarriage or spontaneous abortion. The gestation of 28 weeks to 37 talk about the threat of premature birth (in these terms premature baby can survive).

The reasons for threatened abortion

Often the threat of interruption does not lead the cause of one, but several. To determine what was the starting point sometimes is difficult, but very important for the further tactics of the doctor. The causes of the threat of interruption varied:

• Hormonal disorders

The most common - a lack of progesterone, which is up to 16 weeks produced by the corpus luteum, and after - the placenta. Quite often it sochetannyj progesterone deficiency (pregnancy hormone) and estrogen. As a result, the endometrium does not develop completely, and the fertilized egg can not be safely implanted in the uterus. Excess androgens (male sex hormones) reduce the amount of estrogen, which also leads to the threat of interruption. Also disturbed hormonal functions of other organs (thyroid, pituitary, adrenal glands), which indirectly affect the ovaries may cause a threat to interrupt.

• Infectious and viral diseases

In the first place, are to blame for the threat of interruption of infectious and inflammatory diseases of the female reproductive organs (chlamydia, ureaplasmosis Ureaplasmosis - inflammation of the urogenital system Cytomegalovirus Cytomegalovirus - what is its danger? , Trichomoniasis, and others). The causative agents of these infections cause inflammation in the genitals, rise up and infect the membranes, damaging them and causing a threat of termination. In addition, hitting the placenta, thereby violating food and cause fetal malformations, which exacerbates the threat of interruption. No less important are the common infectious diseases (measles, influenza, pneumonia). In this case, the cause of miscarriage is fever, intoxication, fetal hypoxia, a lack of vitamins.

• Pathology of the uterus

Congenital or acquired diseases of the uterus (fibroids, etc.) are also a cause of threat of termination, due to the deficiency of the structure of the uterus, hormone deficiency, endometrial pathology.

• Cervical incompetence

Or, simply put, is defective, gaping cervix. It can develop as a result of hormone deficiency, and as a result of mechanical injury (abortion, tears of the cervix during labor).

• Genetic abnormalities

Up to 70% of early miscarriages occur due to genetic abnormalities of the fetus. Such disturbances may be related to occupational hazards, adverse environmental conditions, heredity.

• Pathological conditions developing in pregnancy

It preeclampsia, polyhydramnios, placenta previa, resulting in impaired blood supply to the placenta, the fetus begins to suffer, leading to the threat of interruption.

• Somatic chronic diseases of women

Heart disease, hypertension, diabetes mellitus Diabetes - threatening and incurable disease , Pyelonephritis also lead to disruption of utero-placental blood flow and the threat.

Symptoms of threatened abortion

The main symptom of threatened abortion is a pain. The pain can be of a different nature from aching to intense and cramping. Localization of pain is different: in the lower abdomen, the sacrum and lower back. At a later date a woman feels "fossilization" of the uterus - hypertonicity. Sometimes, no complaints of pain, increased uterine tone set on the ultrasound. It can be local (in the specific area) or common. Less common and more dangerous sign - is bleeding from the genital tract. The nature of bleeding is different from smearing to moderate. Brown spotting evidence of the old detachment of the ovum, which was formed after the hematoma and she began to be emptied. Bright, red highlight - a sign of immediate, currently ongoing detachment.

Treatment

The mainstay of treatment of threatened abortion is the emotional and physical rest. To this end, a woman prescribed bed rest and sedatives (motherwort, valerian). Remove the hypertonicity of the uterus help antispasmodics: no-spa, papaverine, spazgan. At a later date, after 16 weeks, used tocolytics such as: partusisten, ginipral, solution of alcohol. To stop the bleeding using gemostatiki (Dicynonum, etamzilat sodium). In the case of hormonal deficiency prescribe drugs that replace progesterone Progesterone - norm and pathology   (Utrozhestan, Duphaston).

Anna Sozinova